NEW YORK (Reuters Health) - After a stroke or mini-stroke,
intensive lowering of "bad" low-density lipoprotein cholesterol
with a statin drug significantly reduces the risk of a second
stroke, according to new data from the Stroke Prevention by
Aggressive Reduction in Cholesterol Levels, or SPARCL, trial.

Previously published data from the trial, which involved
more than 4,700 adults, showed that taking 80 milligrams per
day of atorvastatin, sold as Lipitor, reduced the risk of
stroke and major heart-related events in patients with a
history of recent stroke or mini-stroke (also known as
transient ischemic attack or TIA).

In taking a second look at the data, Dr. Pierre Amarenco
from Bichat University Hospital, Paris, France and the SPARCL
team found that patients who achieved a 50 percent or greater
reduction in their LDL cholesterol level suffered fewer second
stroke events than those who saw no change or an increase in
their LDL cholesterol level.

Specifically, compared with no change or an increase in LDL
cholesterol, patients achieving a 50 percent or greater
reduction in LDL cholesterol had a 31 percent reduction in
stroke risk, and a 37 percent reduction in major coronary
events.

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There was also a trend for a "dose-response" in terms of
decreased stroke risk in patients achieving more or less than a
50 decrease in LDL cholesterol. This, the investigators say,
favors "the hypothesis that a continuous relationship exists
between LDL cholesterol reduction and stroke risk reduction."